ICD-10-CM: Benefits and Enhancement to ICD-9-CM

On or after October 1, 2013, the current diagnosis code sets (ICD-9-CM) will be replaced with the new code – ICD-10-CM. This article discusses the benefits of ICD-10-CM, similarities and differences between the two coding systems, and new features and and additional changes that can be found in ICD-10-CM.

Benefits of ICD-10-CM:

ICD-9-CM is 30 years old, has outdated and obsolete terminology that produce inaccurate and limited data, and is inconsistent with the current medical practice. ICD-10-CM incorporates much greater clinical detail and specificity than ICD-9-CM. ICD-10-CM:

Incorporates much greater specificity and clinical information, which results in:

Includes updated medical terminology that is consistent with the current medical practice;

Provides codes to allow comparison of mortality and morbidity data; and

Provides better data for:

Measuring care furnished to patients;

Designing payment systems;

Processing claims;

Making clinical decisions;

Tracking public health;

Identifying fraud and abuse; and

Conducting research.

New Features Found in ICD-10-CM:

Laterality (left, right, bilateral)

Combination codes for certain conditions and common associated symptoms and manifestations

Combination codes for poisonings and their associated external cause

Obstetric codes identify trimester instead of episode of care

Character “x” is used as a 5th character placeholder in certain 6 character codes to allow for future expansion and to fill in other empty characters when a code that is less than 6 characters in length requires a 7th character

Two types of Excludes notes

Excludes 1 – indicates that the code excluded should never be used with the code where the note is located

Excludes 2 – indicates that the patient may have combination of conditions and both codes could be used

Codes for postoperative complications have been expanded and a distinctions made between intraoperative complications and postprocedural disorders

Additional Changes Found in ICD-10-CM:

Injuries are grouped by anatomical site rather than by type of injury;

Codes and categories have reorganize;

New code definitions; and

The current “V” codes (Factors influencing health status and contact with health services) and “E” codes (External causes of injury and poisoning) are incorporated into the main classification rather than separated into supplemental sections.

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This entry was posted on April 27, 2011 at 9:51 am and is filed under Healthcare IT, HealthCare Reform. You can follow any responses to this entry through the RSS 2.0 feed.
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